Guides / GLP-1 dosing

Trulicity dosage: dose steps, pens and missed doses

Trulicity (dulaglutide) is a once-weekly pen with four strengths. The US and UK labels start people differently, but the missed-dose rule is the same.

By PeptideTracker editorial team · Updated November 8, 2026 · 3 sources

[00] Short answer

US adults start Trulicity (dulaglutide) at 0.75 mg once a week. After 4 weeks it can go to 1.5 mg, then up in 1.5 mg steps every 4 weeks or more, to a maximum of 4.5 mg¹.
Missed dose: take it if at least 3 days (72 hours) are left before your next one. If less, skip it^1–2.
You can change your injection day if your last dose was 3 or more days before the new day^1–2.
Every pen is single-dose: 0.75, 1.5, 3 or 4.5 mg in 0.5 mL. US cartons hold 4 pens¹.

[Tool]Missed dose checkerWork out your own numbers

What is the Trulicity dosing schedule?

In the US, adults start Trulicity at 0.75 mg injected once a week. After 4 weeks, the dose may go up to 1.5 mg for more blood sugar control. If more is needed, it goes up in 1.5 mg steps, with at least 4 weeks at each, to 3 mg and then 4.5 mg¹.

Trulicity (dulaglutide) doses, once weekly: US prescribing information section 2 and UK SmPC section 4.2

Dose	Volume	US adults	UK adults	Children 10+
0.75 mg	0.5 mL	Starting dose for 4 weeks¹	Dose when used alone (monotherapy)²	Starting dose (US and UK)^1–2
1.5 mg	0.5 mL	After 4 weeks, if more control is needed¹	Dose when added to other diabetes medicines²	Maximum, after at least 4 weeks on 0.75 mg^1–2
3 mg	0.5 mL	After at least 4 weeks on 1.5 mg¹	After at least 4 weeks on 1.5 mg, if needed²	Not used
4.5 mg	0.5 mL	Maximum, after at least 4 weeks on 3 mg¹	Maximum, after at least 4 weeks on 3 mg²	Not used

Every strength is a separate single-dose pen holding 0.5 mL^1–2. A dose change means a different pen, not a different amount from the same pen.

Trulicity is approved for type 2 diabetes in adults and children 10 and older. In the US it's also approved to lower the risk of heart attack, stroke and heart-related death in adults with type 2 diabetes who have heart disease or several heart risk factors¹. It isn't approved for weight loss on its own.

You can inject it at any time of day, with or without food, in the belly, thigh or upper arm^1–2. Its half-life is about 5 days¹, which is why it's weekly.

[Tool]Plan your dose steps as datesDose schedule planner with calendar export

Is the Trulicity dose different in the UK?

The UK starting dose depends on what else you take. The UK SmPC gives 0.75 mg once a week when Trulicity is used on its own, and 1.5 mg once a week when it's added to other diabetes medicines². From 1.5 mg, both countries step up to 3 mg and then 4.5 mg, with at least 4 weeks at each^1–2.

The UK SmPC says that when Trulicity is added to a sulphonylurea or insulin, the doctor may lower those doses to cut the risk of low blood sugar².

Do higher Trulicity doses cause more side effects?

A little, in the trial the UK SmPC reports. Over 52 weeks, nausea was reported by 14.2% of people on 1.5 mg, 16.1% on 3 mg and 17.3% on 4.5 mg of Trulicity².

Stomach side effects reported over 52 weeks, by Trulicity dose (UK SmPC section 4.8, phase 3 study)

Dulaglutide dose	Nausea	Diarrhoea	Vomiting	Stopped due to side effects
1.5 mg	14.2%	7.7%	6.4%	6.0%
3 mg	16.1%	12.0%	9.1%	7.0%
4.5 mg	17.3%	11.6%	10.1%	8.5%

Percentages are of people on each dose in the same study².

In the earlier trials of 0.75 mg and 1.5 mg, the SmPC says stomach side effects were mostly mild or moderate, peaked in the first 2 weeks, and dropped quickly over the next 4 weeks². For how this compares with other GLP-1s, see GLP-1 side effects.

What if you miss a Trulicity dose?

Take the missed Trulicity dose as soon as you can if there are at least 3 days (72 hours) until your next scheduled dose. If less than 3 days are left, skip it and take the next dose on your usual day^1–2. Then carry on with your normal weekly day.

Days late on a 7-day schedule → what the US and UK Trulicity labels say

How late	Days until next dose	What the label says
1 day late	6 days	Take it now
2 days late	5 days	Take it now
3 days late	4 days	Take it now
4 days late	3 days	Take it now
5 days late	2 days	Skip it, take the next dose on your usual day
6 days late	1 day	Skip it, take the next dose on your usual day

Built from US section 2.3 and UK section 4.2^1–2. Close to the line? Count hours from the time you'd normally inject: 72 hours or more left means take it.

Neither label gives a restart rule for gaps of 2 weeks or more^1–2. Ask your prescriber which dose to restart on. The missed-dose guide compares Trulicity with Ozempic, Mounjaro and others.

Can you change your Trulicity injection day?

Yes. The US and UK labels let you change your Trulicity day as long as your last dose was 3 or more days (72 hours) before the new day^1–2.

Example: you inject on Monday and want to switch to Thursday. Monday to Thursday is 3 days, so it fits. Monday to Wednesday is only 2 days, so the label says wait until Thursday or later. After that, keep the new day every week. More examples are in changing your GLP-1 injection day.

How do you use a Trulicity pen?

The Trulicity pen is single-dose: one pen, one weekly injection, then you throw it away. There is nothing to dial or measure^1–2.

Uncap
Make sure the pen is locked, then pull off the base cap. Don't put it back on, and don't touch the needle³.
Place and unlock
Put the clear base flat and firmly on your skin, then unlock by turning the lock ring³.
Press and hold
Press and hold the green button. You'll hear a loud click. Keep holding the base against your skin until a second click, about 5 to 10 seconds later, when the needle starts to pull back. The dose is done when the gray plunger is visible³.

US cartons hold 4 single-dose pens¹. The UK SmPC lists packs of 2 and 4 pens and a multipack of 12².

Questions

What is the highest dose of Trulicity?

4.5 mg once a week for adults, in the US and the UK. For children 10 and older, the maximum is 1.5 mg once a week.

Can I go straight from 0.75 mg to 3 mg Trulicity?

The labels step through 1.5 mg first. The US label raises the dose in 1.5 mg steps, with at least 4 weeks on each dose, so 0.75 mg goes to 1.5 mg, then 3 mg, then 4.5 mg.

I missed my Trulicity yesterday. Can I take it today?

Yes. One day late leaves 6 days until your next dose, which is more than the 3 days (72 hours) the label asks for. Take it now, then go back to your usual day.

Is Trulicity used for weight loss?

No. In the US and UK it's approved for type 2 diabetes, and in the US also to lower heart attack and stroke risk in adults with type 2 diabetes. Weight-loss GLP-1s include Wegovy, Zepbound and Saxenda.

How long can Trulicity stay out of the fridge?

Up to 14 days in total at no more than 30°C (86°F), according to the US and UK labels. Don't freeze it, and don't use a pen that has been frozen.

Sources

Checked against Trulicity US prescribing information and Instructions for Use (Lilly, revised 06/2026) and the UK Trulicity SmPC (text revised 25 February 2026). How we check

1Trulicity (dulaglutide) injection, US prescribing information, Eli Lilly (DailyMed, revised 06/2026). sections 1, 2.1 to 2.4, 3, 12.3 and 16
2Trulicity solution for injection in pre-filled pen, UK SmPC (eMC, text revised 25 February 2026). sections 2, 4.1, 4.2, 4.8, 6.3 to 6.6
3Trulicity Instructions for Use, in the US prescribing information (DailyMed, revised 06/2026). steps 1 to 3

This guide explains what labels and published studies say. It isn't medical advice and doesn't replace your prescriber or pharmacist.

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